nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2017-1S-69-73nnp-730Research ArticleCLINICAL OBSERVATIONSКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯSuper-refractory status epilepticus and ischemic stroke: A clinical case reportСуперрефрактерный эпилептический статус и ишемический инсульт: описание клинического случаяКотовА. С.KotovA. S.

129110 Москва, ул. Щепкина, 61/2

61/2, Shchepkin St., Moscow 129110

alex-013@yandex.ruЛитвиненкоМ. А.LitvinenkoM. A.

129110 Москва, ул. Щепкина, 61/2

61/2, Shchepkin St., Moscow 129110

СандуЕ. А.SanduE. A.

129110 Москва, ул. Щепкина, 61/2

61/2, Shchepkin St., Moscow 129110

АлаковаМ. А.AlakovaM. A.

129110 Москва, ул. Щепкина, 61/2

61/2, Shchepkin St., Moscow 129110

СорокинаЕ. К.SorokinaE. K.

129110 Москва, ул. Щепкина, 61/2

61/2, Shchepkin St., Moscow 129110

ГБУЗ МО «Московский областной научно-исследовательский клинический институт им. М.Ф. Владимирского»РоссияM.F. Vladimirsky Moscow Regional Research Clinical InstituteRussian Federation20171406201791SSPECIAL ISSUE: EPILEPSY6973Copyright © Kotov A.S., Litvinenko M.A., Sandu E.A., Alakova M.A., Sorokina E.K., 20172017Котов А.С., Литвиненко М.А., Санду Е.А., Алакова М.А., Сорокина Е.К.Kotov A.S., Litvinenko M.A., Sandu E.A., Alakova M.A., Sorokina E.K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/730

Generalized convulsive status epilepticus (GCSE) is the most dangerous type of status epilepticus. The paper describes a clinical case of a 33-year-old female patient admitted to an intensive care unit for diagnosed ischemic stroke in the posterior cerebral artery bed and GCSE. EEG showed diffuse discharges of epileptiform activity against a flattened background (an EEG correlate of the terminal phase of status epilepticus). Intensive treatment was performed; the outcome of the disease was fatal. The article discusses the possible causes of status epilepticus and its treatment policy in the patient.

Генерализованный судорожный эпилептический статус (ГСЭС) – самый опасный тип эпилептического статуса. Приводим описание клинического случая пациентки 33 лет, поступившей в реанимационное отделение с диагнозом: «Ишемический инсульт в бассейне задней мозговой артерии. ГСЭС». При электроэнцефалографии наблюдались диффузные разряды эпилептиформной активности на уплощенном фоне (электрофизиологический коррелят терминальной фазы эпилептического статуса). Проводилось интенсивное лечение, исход заболевания был фатальным. В статье обсуждаются возможные причины и тактика лечения эпилептического статуса у пациентки.

судорожный эпилептический статусишемический инсультэпилепсияgeneralized convulsive status epilepticusischemic strokeepilepsyReferencesTrinka E, Cock H, Hesdorffer D, et al. A definition and classification of status epilepticus – Report of the ILAE Task Force on Classification of Status Epilepticus. Epilepsia. 2015 Oct;56(10):1515-23. doi: 10.1111/epi.13121Trinka E, Cock H, Hesdorffer D, et al. A definition and classification of status epilepticus – Report of the ILAE Task Force on Classification of Status Epilepticus. Epilepsia. 2015 Oct;56(10):1515-23. doi: 10.1111/epi.13121Bleck TP. Refractory status epilepticus. Curr Opin Crit Care. 2005 Apr;11(2):117-20. doi: 10.1097/01.ccx.0000157079.72999.87Bleck TP. Refractory status epilepticus. Curr Opin Crit Care. 2005 Apr;11(2):117-20. doi: 10.1097/01.ccx.0000157079.72999.87Rossetti AO, Bromfield EB. Efficacy of rapid IV administration of valproic acid for status epilepticus. Neurology. 2005 Aug 9;65(3):500-1; author reply 500-1. doi: 10.1212/WNL.65.3.500-aRossetti AO, Bromfield EB. Efficacy of rapid IV administration of valproic acid for status epilepticus. Neurology. 2005 Aug 9;65(3):500-1; author reply 500-1. doi: 10.1212/WNL.65.3.500-aBerg AT, Berkovic SF, Brodie MJ, et al. Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE Commission on Classification and Terminology, 2005-2009. Epilepsia. 2010 Apr;51(4):676-85. doi: 10.1111/j.1528-1167.2010.02522.xBerg AT, Berkovic SF, Brodie MJ, et al. Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE Commission on Classification and Terminology, 2005-2009. Epilepsia. 2010 Apr;51(4):676-85. doi: 10.1111/j.1528-1167.2010.02522.xBauer G, Trinka E. Seizures, syndromes and classifications. Epileptic Disord. 2006 Jun;8(2):162-3.Bauer G, Trinka E. Seizures, syndromes and classifications. Epileptic Disord. 2006 Jun;8(2):162-3.Добрынина ЛА, Калашникова ЛА, Павлова ЛН. Ишемический инсульт в молодом возрасте. Журнал неврологи и психиатрии им. С.С. Корсакова. 2011;111(3):4-8 [Dobrynina LA, Kalashnikova LA, Pavlova LN. Ischemic stroke in young age. Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova = SS Korsakov Journal of Neurology and Psychiatry. 2011;111(3):4-8 (In Russ.)].Добрынина ЛА, Калашникова ЛА, Павлова ЛН. Ишемический инсульт в молодом возрасте. Журнал неврологи и психиатрии им. С.С. Корсакова. 2011;111(3):4-8 [Dobrynina LA, Kalashnikova LA, Pavlova LN. Ischemic stroke in young age. Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova = SS Korsakov Journal of Neurology and Psychiatry. 2011;111(3):4-8 (In Russ.)].Lee RM, Brown MA, Branch DW, et al. Anticardiolipin and anti-beta2-glycoprotein-I antibodies in preeclampsia. Obstet Gynecol. 2003 Aug;102(2):294-300.Lee RM, Brown MA, Branch DW, et al. Anticardiolipin and anti-beta2-glycoprotein-I antibodies in preeclampsia. Obstet Gynecol. 2003 Aug;102(2):294-300.Старченко АА. Клиническая нейрореаниматология: Руководство для врачей. Москва: МЕДпресс-информ; 2007. 942 с. [Starchenko AA. Klinicheskaya neiroreanimatologiya: Rukovodstvo dlya vrachei [Clinical neuroreanimatology: A guide for doctors]. Moscow: MEDpress-inform; 2007. 942 p.].Старченко АА. Клиническая нейрореаниматология: Руководство для врачей. Москва: МЕДпресс-информ; 2007. 942 с. [Starchenko AA. Klinicheskaya neiroreanimatologiya: Rukovodstvo dlya vrachei [Clinical neuroreanimatology: A guide for doctors]. Moscow: MEDpress-inform; 2007. 942 p.].Рузикулов ММ, Джинджахидзе РС, Лазарев ВА. Инсультоподобное клиническое течение опухолевых заболеваний головного мозга. Доктор.Ру. 2014;6(94):26-8 [Ruzikulov MM, Dzhindzhakhidze RS, Lazarev VA. Stroke-like clinical course of neoplastic diseases of the brain. Doktor.Ru. 2014;6(94):26-8 (In Russ.)].Рузикулов ММ, Джинджахидзе РС, Лазарев ВА. Инсультоподобное клиническое течение опухолевых заболеваний головного мозга. Доктор.Ру. 2014;6(94):26-8 [Ruzikulov MM, Dzhindzhakhidze RS, Lazarev VA. Stroke-like clinical course of neoplastic diseases of the brain. Doktor.Ru. 2014;6(94):26-8 (In Russ.)].Ferrier CH, Aronica E, Leijten FS, et al. Electrocorticography discharge patterns in patients with a cavernous hemangioma and pharmacoresistent epilepsy. J Neurosurg. 2007 Sep;107(3):495-503. doi: 10.3171/JNS-07/09/0495Ferrier CH, Aronica E, Leijten FS, et al. Electrocorticography discharge patterns in patients with a cavernous hemangioma and pharmacoresistent epilepsy. J Neurosurg. 2007 Sep;107(3):495-503. doi: 10.3171/JNS-07/09/0495Barkovich AJ. Congenital malformations of the brain and skull. In: Barkovich AJ, editor. Pediatric neuroimaging. 4th ed. Philadelphia: Lippincott, Williams & Wilkins; 2005. P. 291-439.Barkovich AJ. Congenital malformations of the brain and skull. In: Barkovich AJ, editor. Pediatric neuroimaging. 4th ed. Philadelphia: Lippincott, Williams & Wilkins; 2005. P. 291-439.Blü mcke I, Thom M, Aronica E, et al. The clinicopathologic spectrum of focal cortical dysplasias: a consensus classification proposed by an ad hoc Task Force of the ILAE Diagnostic Methods Commission. Epilepsia. 2011 Jan;52(1):158-74. doi: 10.1111/j.1528-1167.2010.02777.xBlü mcke I, Thom M, Aronica E, et al. The clinicopathologic spectrum of focal cortical dysplasias: a consensus classification proposed by an ad hoc Task Force of the ILAE Diagnostic Methods Commission. Epilepsia. 2011 Jan;52(1):158-74. doi: 10.1111/j.1528-1167.2010.02777.xKrsek P, Maton B, Korman B, et al. Different features of histopathological subtypes of pediatric focal cortical dysplasia. Ann Neurol. 2008 Jun;63(6):758-69. doi: 10.1002/ana.21398Krsek P, Maton B, Korman B, et al. Different features of histopathological subtypes of pediatric focal cortical dysplasia. Ann Neurol. 2008 Jun;63(6):758-69. doi: 10.1002/ana.21398Palmini A, Lü ders HO. Classification issues in malformations caused by abnormalities of cortical development. Neurosurg Clin N Am. 2002 Jan;13(1):1-16, vii. doi: 10.1016/S1042-3680(02)80002-XPalmini A, Lü ders HO. Classification issues in malformations caused by abnormalities of cortical development. Neurosurg Clin N Am. 2002 Jan;13(1):1-16, vii. doi: 10.1016/S1042-3680(02)80002-XClaassen J, Mayer SA, Kowalski RG, et al. Detection of electrographic seizures with continuous EEG monitoring in critically ill patients. Neurology. 2004 May 25;62(10): 1743-8. doi: 10.1212/01.WNL.0000125184.88797.62Claassen J, Mayer SA, Kowalski RG, et al. Detection of electrographic seizures with continuous EEG monitoring in critically ill patients. Neurology. 2004 May 25;62(10): 1743-8. doi: 10.1212/01.WNL.0000125184.88797.62Vespa PM, Nuwer MR, Nenov V, et al. Increased incidence and impact of nonconvulsive and convulsive seizures after traumatic brain injury as detected by continuous electroencephalographic monitoring. J Neurosurg. 1999 Nov;91(5):750-60. doi: 10.3171/jns.1999.91.5.0750Vespa PM, Nuwer MR, Nenov V, et al. Increased incidence and impact of nonconvulsive and convulsive seizures after traumatic brain injury as detected by continuous electroencephalographic monitoring. J Neurosurg. 1999 Nov;91(5):750-60. doi: 10.3171/jns.1999.91.5.0750

The authors declare that there are no conflicts of interest present.